球囊支架对吻术对冠状动脉分叉病变的保护作用

摘要

目的：探讨球囊支架对吻术对冠状动脉分叉病变的保护作用。方法选取2013年6月—2015年6月中山市博爱医院心内科收治的冠状动脉分叉病变患者100例，均行经皮冠状动脉介入治疗（pCI），将所有患者随机分为对照组和试验组，各50例。对照组患者使用传统保护导丝术行 pCI，试验组患者使用球囊支架对吻术行 pCI。记录两者患者术中和术后主支及边支 TIMI 血流分级、手术时间及并发症发生情况；pCI 术后6个月，复查冠状动脉造影时记录主支支架内再狭窄、边支狭窄加重或闭塞发生率。结果两组患者术中和术后主支 TIMI 血流3级所占比例比较，差异无统计学意义（P >0.05）；试验组患者术中和术后边支 TIMI 血流3级所占比例高于对照组，手术时间短于对照组，并发症发生率低于对照组（P <0.05）。pCI 术后6个月，两组患者主支支架内再狭窄发生率比较，差异无统计学意义（P >0.05）；试验组患者边支狭窄加重或闭塞发生率低于对照组（P <0.05）。结论球囊支架对吻术对冠状动脉分叉病变边支具有保护作用，能有效提高术中和术后边支 TIMI 血流分级，降低并发症发生率，改善患者预后。%Objective To investigate the protective effects of balloon - stent anastomosis on coronary bifurcation lesions. Methods From June 2013 to June 2015,a total of 100 patients with coronary bifurcation lesions were selected in the Department of Cardiology,Boai Hospital of Zhongshan,and they were randomly divided into control group and test group,each of 50 cases. patients of control group received traditional routine pCI,while patients of test group received balloon - stent anastomosis during pCI. TIMI flow grades of main branch and side branch during pCI and after pCI,duration of pCI and incidence of complications were compared between the two groups;all of the patients received reexamination of coronary angiography after 6 months of pCI,and incidence of in - stent restenosis of main branch,stenosis exacerbation or occlusion of side branch was rerecorded. Results No statistically significant differences of proportion of 3 - grade TIMI flow of main branch was found between the two groups during pCI or after pCI(P > 0. 05);the proportion of 3 - grade TIMI flow of side branch of test group was statistically significantly higher than that of control group during pCI and after pCI,respectively,duration of pCI of test group was statistically significantly shorter than that of control group,while incidence of complications of test group was statistically significantly lower than that of control group( P < 0. 05). After 6 months of pCI,no statistically significant differences of incidence of in - stent restenosis of main branch was found between the two groups(P > 0. 05),while incidence of stenosis exacerbation or occlusion of side branch of test group was statistically significantly lower than that of control group(P <0. 05). Conclusion Balloon - stent anastomosis has certain protective effects on side branch of coronary bifurcation lesions, can effectively improve the TIMI flow grades of side branch during pCI and after pCI,reduce the incidence of complications, eventually improve the prognosis.